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Updated: Jul 12, 2025
Evaluation of Capillary and Other Vessel Contribution to Macular Perfusion Density Measured with Optical Coherence Tomography Angiography
Published on: February 18, 2022
Effect of levetiracetam on ocular perfusion measure with optical coherence tomography angiography
Ahmet Kaderli1, Hülya Kayılıoğlu2, Sema Tamer Kaderli1
1Ophthalmology Department, Mugla Sitki Kocman University Research and Training Hospital, Muğla, Turkey.
Insights
Levetiracetam, an epilepsy medication, may reduce choroidal blood flow in children. Retinal blood flow remained unaffected in this optical coherence tomography angiography study, indicating specific vascular changes.
Area of Science:
- Ophthalmology
- Neurology
- Pharmacology
Background:
- Epilepsy affects numerous children worldwide.
- Antiepileptic drugs are crucial for managing epilepsy.
- Understanding drug-specific ocular effects is vital for patient care.
Purpose of the Study:
- To assess the impact of levetiracetam on macular and optic nerve head blood flow in pediatric epilepsy patients.
- To evaluate changes using optical coherence tomography angiography (OCTA) after at least 12 months of treatment.
Main Methods:
- A comparative study involving 33 pediatric epilepsy patients treated with levetiracetam and 30 healthy controls.
- Optical coherence tomography angiography (OCTA) was employed to measure perfusion in the optic nerve head and macula.
- Mean ocular perfusion pressure was calculated for all participants.
Main Results:
- A significant reduction in choriocapillaris flow area was observed in the levetiracetam group compared to controls (p=0.006).
- No significant differences were found in foveal avascular zone or vessel densities in the macula and optic nerve head between groups (p>0.05).
- Mean ocular perfusion pressure did not differ significantly between the study and control groups (p=0.211).
Conclusions:
- Levetiracetam treatment was associated with reduced choroidal perfusion in pediatric epilepsy patients.
- Retinal perfusion, specifically in the macula and optic nerve head, was not significantly affected by levetiracetam.
- This optical coherence tomography angiography study highlights potential choroidal vascular changes with levetiracetam use in children.
Purpose:
To evaluate using optical coherence tomography angiography the macular and optic nerve head blood flow in pediatric patients with epilepsy treated with levetiracetam for at least 12 months.
Methods:
This study included 33 pediatric patients with epilepsy and 30 sex- and age-matched healthy volunteer children were included in the study. Optical coherence tomography angiography was used to evaluate the optic nerve head and macular perfusion changes. The mean ocular perfusion pressures were also calculated. Patients who were using multiple antiepileptic drugs or had a prior history of using different drugs were excluded.
Results:
The choriocapillaris flow area was significantly lower in the Study Group than in the Control Group (p=0.006). However, the foveal avascular zone and vessel densities of the macula in the superficial capillary plexus, deep capillary plexus, and optic nerve head of the study group were not significantly different from those of the control group (p>0.05). Moreover, no significant difference in means of mean ocular perfusion pressure was found between the two groups (p=0.211). No obvious correlation was found between treatment duration and optical coherence tomography angiography parameters or mean ocular perfusion pressure.
Conclusion:
Choroidal perfusion was reduced in children taking levetiracetam compared with that in the control group, whereas retinal perfusion was not affected in this optical coherence tomography angiography study.
